C2A - 04: BURNOUT AND OTHER ISSUES: HOW GENERAL SURGEONS TRANSITION TO INDEPENDENT SURGICAL PRACTICE
Mohammed Firdouse, BSc, Caitlin Chrystoja, Jaime Escallon, Sandra DeMontbrun, Tulin D Cil; University of Toronto

Background: The transition from surgical residency to independent practice can be a challenging period.  It involves establishing a new clinical practice and fulfilling academic, research and educational roles. The specific issues that may affect surgeons during this transition have not been well studied.

Aim:  To assess the issues affecting recent general surgery graduates across Canada and to determine the prevalence of burnout in this early career population.

Methods: An email invitation to complete a 55-item survey along with the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) was sent to all recent graduates of general surgery programs across Canada.  The Chi-square test, or Fisher’s Exact test were used as appropriate to compare demographic and survey characteristics with burnout. Multivariable logistic regression was performed.

Results: A total of 88 of the 584 general surgeons contacted responded to the survey (15%); 51/88 surgeons (58.0%) were classified as burnt out according to the MBI-HSS. Factors associated with burnout included: lack of confidence in operative decision making as an independent practitioner (p=0.02), lack of confidence in preparation to transition from a resident/fellow to an attending role (p=0.03), and self-perception of experiencing burnout (p=0.03). A lack of support at work was associated with increased odds of having burnout (OR 4.33, 95% CI 1.68-11.20, p=0.003), as was feeling that the discussion of burnout in the workplace is taboo (OR 3.05, 95% CI 1.02-9.13, p=0.05).  Most surgeons (68.2%) were not comfortable in their abilities to handle the business aspect of practice. The majority (60.2%) believed that a transition to independent practice program would be beneficial to recent surgical graduates.

Conclusions: Our data showed high prevalence of burnout among recently graduated general surgeons across Canada. Although most surgeons felt satisfied with their surgical skills, they were not confident in their managerial and administrative skills required to run a successful independent practice.